Madi Haifa A, Morgan Stephen J, Ghosh Saurabh
Sunderland Eye Infirmary, Queen Alexandra Road, Sunderland SR2 9HP, UK.
Am J Ophthalmol Case Rep. 2017 Sep 1;8:25-27. doi: 10.1016/j.ajoc.2017.08.002. eCollection 2017 Dec.
We report a case of corneal endothelial graft failure secondary to dexamethasone intravitreal implant (Ozurdex™) migration into the anterior chamber (AC).
A 53-year-old man with a history of bilateral idiopathic chronic uveitis, had a right anterior vitrectomy and AC intraocular lens (ACIOL) with a peripheral iridotomy. He received an intravitreal Ozurdex™ implant for right cystoid macular oedema (CMO). Three months later he developed pseudophakic bullous keratopathy and underwent a Descemet stripping automated endothelial keratoplasty (DSAEK), combined with IOL exchange (ACIOL explantation followed by scleral fixated posterior chamber IOL). He developed recurrent CMO post-operatively, for which he had a second Ozurdex™ implant. Six weeks following the implant he presented with reduced vision and corneal graft failure with migration of the Ozurdex™ implant into the AC. Despite prompt surgical removal of the implant, the graft did not recover and he underwent a repeat DSAEK.
Ophthalmologists should be aware of this adverse event and the importance of early implant removal to reduce the risk of permanent corneal oedema.
我们报告一例因地塞米松玻璃体内植入物(Ozurdex™)迁移至前房导致角膜内皮移植失败的病例。
一名有双侧特发性慢性葡萄膜炎病史的53岁男性,接受了右眼前部玻璃体切除术及带周边虹膜切开术的前房人工晶状体(ACIOL)植入。他因右眼黄斑囊样水肿(CMO)接受了玻璃体内Ozurdex™植入。三个月后,他发生了人工晶状体性大泡性角膜病变,并接受了后弹力层剥除自动内皮角膜移植术(DSAEK),同时进行了人工晶状体置换(取出ACIOL,随后植入巩膜固定后房型人工晶状体)。术后他出现复发性CMO,为此他接受了第二次Ozurdex™植入。植入六周后,他出现视力下降及角膜移植失败,Ozurdex™植入物迁移至前房。尽管及时手术取出了植入物,但移植片未恢复,他又接受了一次DSAEK。
眼科医生应了解这一不良事件以及早期取出植入物以降低永久性角膜水肿风险的重要性。